Medical providers in North Carolina have laws unique to running their practices. Whether it is a hospital, clinic or practitioner, health care businesses find themselves regulated under two main legal prongs: Anti-Kickback and Stark Laws.
Understanding how these policies may impact your medical business is essential to remaining compliant. Allow the professionals at Connors Morgan, PLLC to give you the insight required to stay out of the hot seat and keep your license intact.
Medicare and Medicaid fraud is a serious issue among the health care system. Providers often find themselves facing the temptation to break the law. The Anti-Kickback Statute (AKS) is a federal law born out of repeated attempts to game the system and make money defrauding government programs.
The AKS criminalizes specific actions that benefit health care providers should they accept money, services or goods in exchange for increasing federal health care claims. It aims to keep healthcare-related companies from providing inducements to each other in exchange for driving business for Medicaid, Medicare and other government health programs.
A similar policy exists in the form of the Stark laws. These laws have procedures in place to stop physicians from referring patients covered by government programs to other businesses owned by the doctor. For example, a doctor cannot suggest a Medicare patient to a laboratory for blood work if the physician has any financial share in the lab. This prevents the double-dipping of federal health care benefit payments.
While these explanations are broad, they may help make sense of complicated laws. If you or your practice is in danger of violating either of these provisions, you may want to refer to our website for ways to assist.